PERFORMANCE: East Sussex Healthcare Trust has been rated as ‘inadequate’ by the Care Quality Commission.
However, a decision on whether to place the trust in special measures has been deferred after the CQC returned to re-inspect the trust this week.
It has been six months since the first inspection took place. A CQC spokesman said a decision on whether to place the trust in special measures would not be made until the chief inspector of hospitals had a chance to consider the findings of the latest inspection.
He added that early indications showed that improvements had been made but there were still concerns over the leadership and culture of the trust.
Inspectors were concerned by the disconnect they found between senior management and other staff.
The report said: “We saw a culture where staff were afraid to speak out or to share their concerns openly.”
Inspectors also saw a higher number of staff than expected who wished to remain anonymous.
They found that waiting times in outpatient services were “excessive” and that some specialisms had long waiting lists, with rheumatology patients having sometimes waited 48-49 weeks for treatment.
“Outstanding” practice was found in clinical leadership and among consultants in critical care and nurse led discharge.
There were low staffing levels in surgery, maternity and pharmacy.
The team also found that at the time of inspection the trust had higher than expected mortality levels.
It was rated “good” for how caring its services were.
The inspectors found bad feeling among local stakeholders over the recent reconfiguration of services. The trust had centralised consultant led maternity and paediatrics at Conquest Hospital. The report said: “The trust had just undertaken a major and contentious reconfiguration of some of its clinical services. We did not see a clear vision for the trust going forward from this.
“Following the reconfiguration, there was a loss of trust from some of the stakeholders in the trust management.”
Trust chief executive Darren Grayson said: “We are incredibly disappointed to receive the ‘inadequate’ rating from the CQC, although we welcome the feedback from their inspection this week that improvements have already been made since they inspected last September. The reports reflect the journey we are on as an organisation and the immense changes we have made over recent years.
“It is testament to our excellent frontline and support staff that they are recognised as delivering compassionate care to the thousands of patients who need our services every day.”
He added: “I have always been honest about the fact that it isn’t an overnight job to change the culture of a large complex organisation such as ours and that there is always more that we can and want to do. We have not stood still in the many months that we have been waiting for the CQC to publish their reports.”
CQC chief inspector of hospitals Sir Mike Richards said: “When we inspected East Sussex Healthcare in September, we were extremely concerned at the disconnect we identified between the senior team and the staff working on the frontline. We saw no sign of a clear vision and strategy and a lack of response to concerns raised by staff. We had specific serious concerns about maternity, surgery and outpatients.
“Our recent inspection indicates there have been improvements in important areas for patients, but I am still concerned about cultural and leadership issues at the trust. I will not be making a judgment about special measures until we have fully assessed the results of our most recent inspection.”
A joint statement from the three Clinical Commissioning Groups in the area said: “The CQC has highlighted areas of concern which we, as clinically-led commissioners of local NHS services, take very seriously.
“It is clear that the trust needs to continue its journey of improvement and take further action to ensure all patients receive the best possible care.
“CCGs will continue working, in partnership with the trust, to drive improvements to the quality and safety of services for local people, as we have already done for maternity, stroke and surgical services where sustained improvements are clear. We are pleased the CQC has recognised these improvements are necessary.
“Challenges still remain, and we will carefully review these reports and work with the trust and other partners to secure further improvement where required.
“We are pleased to note the areas in which the trust is rated ‘good’, particularly in delivering caring services across the board. This reflects excellent nursing leadership and the professionalism and skill of many dedicated staff.”